POINT PREVENTION PLAN
NUTRITION FOR ALL AGES
TWO BRUSH AND FLOSS SYSTEM
ORIENTATION AND EDUCATION
DENTAL HEALTH AWARENESS FOR SENIORS
AND DENTAL HEALTH
NUTRITION AND PERIODONTAL DISEASE
PREVENTIVE CARE OF ORTHODONTIC APPLIANCES
"IF YOU'RE LOOKING FOR WEALTH INVEST IN YOUR HEALTH"
Suppose I asked you to list the things that you needed to be happy. You would probably say: money, spouse, children, house, clothes, car, TV, stereo, VCR, boat, etc. Although the order may differ, people admit to needing a list of things to be happy.
Now, suppose I asked you to select the one thing that is essential to your happiness without which happiness would be impossible. What would it be? Money? After all, can't you buy everything with money? Ask the millionaire with a toothache.
Money can't buy health. It is by far your most valuable possession. Without it you cannot enjoy any of the things on your list. Did health appear on your list?
The interesting thing is that if you're like most people, you didn't include health on your list. Why? Because people take their health for granted. You don't even think about it until you have problems. As long as it doesn't hurt, why bother? Why go looking for trouble? The fact is, that many people find themselves in trouble, quite unexpectedly. Do you think people with dentures intended to have problems with their teeth? Of course not. They often consider themselves as victims of heredity or circumstance, even though the problem is totally preventable. The secret is learning to prevent problems.
Any intelligent person, if
given a clear choice between health and disease, would
choose health. Yet, many people see health professionals
only when they have problems. In dentistry, for example,
there was a time when the only treatment was to pull the
offending tooth without the benefit of anaesthetic. Even
though dentistry has become almost totally painless, many
people still use their fear of pain as an excuse to avoid
all dental services, (even the preventive ones). They may
even use the cost of dental services as an excuse, as if
they value a new stereo or VCR more than a healthy smile.
In fact, people spend more on lottery tickets and hair
cuts, than they do on oral health care. They must think
that they can beat the cost of dental care by simply
staying away from the dental office. In the end, all they
learn is the high cost of neglect.
If preventive information and services are available to help you keep your teeth for a lifetime and avoid more than $7,500 worth of recurrent repairs and dentures, why wouldn't you make a point of finding out about them by going for a consultation or check-up? Its not just a matter of how much its going to cost to fix things. Its a matter of learning how to get what you've got healthy before you invest in repairs. If you can learn how to stop the progress of the disease that is damaging your teeth and gums in the first place, then when the repairs are done, then tend to stay done.
Treating effects by repairing, without treating causes by preventing, can be a very expensive lesson in chasing without catching. Dentistry has much more to offer today than drilling, filling, and pulling. It can also provide you with an accurate diagnosis of the level of your oral health, the latest preventive techniques, and the information you need to get the best value from all dental services over a lifetime. The cost of prevention and regular care is always far less than the cost of ignorance and neglect. Daily brushing & flossing and regular check-ups may at first seem to be a hassle, but they are nowhere near the hassle of toothaches, bad breath, bleeding gums, periodontal abscesses, surgery, bridge-work, and dentures.
For your sake, don't wait until it hurts. Ask your dentist or hygienist about their preventive services. If you haven't already learned the benefits of brushing & flossing and regular check-ups, you really should look into it. Ask about bacterial plaque and how to control it. Ask about fluorides and sealants. Ask about the diet patterns that support oral health. Remember, if you can get your mouth healthy, the rest of the body tends to follow suit. When one part of the body gets healthy, the whole body benefits. Why not learn how to increase your health as you get older instead of slowly letting it get worse?
I guarantee, you'll never regret learning how to improve your dental health. Besides, nobody will take as good care of your teeth as you will, and there is little any dentist or hygienist can do that will make up for what you won't do. If you can learn to recognize the signs on the road to health, and the signs on the road to disease, you can at least see where you're headed. With professional help, you can learn to recognize your problem areas while they are still reversible. You can even learn how to put distance between yourself and the possibility of dental disease.
Please take a good look at your list of priorities in life. If you're looking for wealth, invest in your health, while you still have it. You may also be surprised to find, that when you've got good health, all you really need is a sunny day, a smile from a loved one, and it all makes sense. When you're healthy, life is not a cry, its a song.
Yours in Healthy Smiles,
Endorsed by the Ontario
Dental Association since 1982
TEETH FOR A LIFETIME
by W. K. Hettenhausen D.D.S.
Founding Officer & Executive Director
The first "Your Teeth For a Lifetime" article appeared in Volume 53, No. 2, of the O.D.A. Journal, in February 1976. The "Standardized Oral Hygiene Preventive Dental Education Kit" has since been tested on more than 2,500 private patients. It is a very effective system and can yield impressive results even when pitted against periodontal disease in its irreversible stages.
Since 1976, with the support of members of the Thunder Bay Dental Association, I limited my practice to teaching primary prevention and nutrition. Just as a dentist who limits his dental practice to crown and bridge can become exceedingly proficient in that discipline, by limiting my practice to primary prevention I hoped to do the same. As I begin my fourteenth year of this preventive discipline, it is my privilege to share some of the insights gained in this endeavour.
THE TWO BRUSH AND FLOSS SYSTEM
This system maximizes cleaning & gum massage, and minimizes abrasion and periodontal damage. Although a single multi-tufted brush can achieve similar results, there are definite advantages in using specialized brushes for both sulcus brushing and gum massage & general cleaning.
STEP 1: Sulcus
Using a pencil or finger-tip grip, the brush is gently vibrated at a 45o angle into the sulcus then out. It is used once a day, without toothpaste to minimize abrasion, in an open-ended time situation (eg. while relaxing, watching TV or listening to the stereo etc.).
It helps to do three things:
STEP 2: Flossing
Odour: A fetid smell (often with a metallic taste), on the floss can be an indication of the anaerobic bacterial activity that is one of the early symptoms of periodontal disease.
Blood: Healthy gums don't bleed and blood on the floss can indicates a lack of epithelial integrity. If chronic PLAQUE accumulation is the primary causative factor then all bleeding will stop, with proper flossing, between the 6th and the 7th day.
STEP 3: Gum
Massage & General Cleaning
STEP 4: Disclosing
This is by far one of the most effective non-verbal teaching aids for preventive dentistry. Once patients can easily see the extent of their PLAQUE formation and its effect on oral hard and soft tissues, the mere suggestion that it is "alive and kicking" has them thinking that its their idea that they should take better care of their teeth. Accurate disclosing is the cornerstone of any effective oral health evaluation program.
1 ORAL HEALTH, April 1985 / Vol.75 / No.4
STEP 5: Take your
clean teeth to a dental office regularly to show them
THE CANADIAN DENTAL ASSOCIATION'S
A dietary record can be helpful in learning about individual diet patterns and their effects on the oral environment. An understanding of the basic requirements for generating dental health can also provide valuable insights into the potential of preventive dentistry to affect total health.
The following information is not only intended to provide help with the diagnosis of dental health problems, but it is also designed to provide an overview of nutrition and encourage interest in understanding the basic nutritional requirements for long term health. There are no commandments telling you what to eat or not to eat. Only suggestions for improvements that you must test for yourself. Every person is an individual, and different lifestyles have different nutritional requirements. If you wish to increase your health as you get older, then you must learn how to better satisfy your body's needs.
BALANCED VERSUS UNBALANCED FOODS
Foods that have everything necessary to support life are considered balanced. Foods that have too much or too little of something to support life are considered unbalanced. From a scientific point of view, all foods are made up of different parts or components.
nutrients (the large parts):
nutrients (the small parts):
A BIOLOGICAL CONCENTRATION PERSPECTIVE:
The concentrations of these components are limited in living things. For example, the highest concentration of sugar found naturally is about 80% (in honey). The concentration of sugar in the sugar bowl is 100%, or 20% more refined than the highest concentration found or supported in any living system. You are what you eat, and if you constantly eat concentrations that exceed the limits found or tolerated in living things, imbalance tends to result, and you may end up with chronic health problems.
Remember, there are more than 50 essential nutrients, and it is not just the concentration of any one nutrient, but rather the relationship of all of the nutrients that are necessary for continued health. For example, it is not the sugar itself that is harmful, but what is missing. The sugar in the sugar cane is the same sugar that is found in the sugar bowl. The only difference is in the concentration. The sugar in the cane is only 26%. We say that it is balanced (organically proportioned), because it is surrounded by the proteins, fats, vitamins, minerals, trace elements, and water, of the living sugar cane plant.
White sugar (sucrose), is considered unbalanced because it is refined beyond living limits. All of the "impurities" (minerals, vitamins and trace elements) have been removed. It is a refined food source for bacterial PLAQUE which is the cause of most dental disease. Damage to the teeth and gums is often a sign that sugar levels in the diet are high and plaque removal techniques are poor.
It is not as difficult as
it may seem. You don't have to be a scientist to figure
out whether your diet is balanced or not. If you want to
be healthy, eat healthy food. Remember, foods that are
alive, or very close to their living state, must have all
of the nutrients necessary to support life in them, or
they wouldn't be able to grow in the first place. An
apple is an example of a food that is actually alive when
you eat it. If you put it on the ground, it will drop a
root, and a tree will come. You can easily prove that it
is life generative. Foods that are highly processed and
contain a large number of chemical preservatives to
inhibit the growth opf bacteria are far less likely to
support your health, than foods that are fresh and
healthy (& not over-cooked) when you eat them.
General Comments: Diet on the whole appears to be adequate. (The average North American Diet tends to have more than an adequate amount of Macro nutrients, and a less than adequate amount of Micronutrients.
Strong Points: Variety in the diet pattern, properly prepared meals, fresh salads, and raw fruits and vegetables contribute to health and balance. Firm fibrous foods (like apples) provide additional chewing which tends to increase salivary flow, and strengthen the gums and supporting structures.
Weak Points: Coffee and tea + 1 to 2 teaspoons sugar can promote the rapid growth of PLAQUE, and sticky refined starches can contribute to the formation of hard deposits on the teeth. A very low yellow, green or dark green leafy vegetable intake can lead to a borderline Vitamin A (Beta-Carotene) deficiency which can lower resistance to gum disease. Low citrus fruit intake (Vitamin C) deficiency can contribute to delayed healing of gum tissues.
The following suggestions increase balance and the nutritious value of the foods eaten:
The goal of these
suggestions is not blind belief. Hopefully they will
stimulate your interest in reading labels and being more
concerned with developing a diet pattern that suits your
particular needs. The object is to experiment with a
healthy diet. If you keep your mouth healthy and clean by
brushing and flossing every day... you'll be able to
taste the truth in good nutrition.
Yours in Healthy Smiles,
Wm. Hettenhausen DDS,
The mouth is a "Gateway to Health" and can be used as an excellent barometer' of nutritional status. A simple diet questionnaire and nutrition survey included with the patient history can provide an excellent opportunity to target specific patients for more comprehensive study. Not only does this alert patients of the need to examine the relationship between their diet pattern and their oral health, but also it broadens the dental practitioner's diagnostic skills in recognizing disease patterns in which dietary habits are a major contributing factor. Recurrent dental caries (tooth decay) and chronic periodontal problems can prove extremely resistant to treatment if the symptoms are the result of underlying systemic factors related to poor nutrition.
The effects of diet on oral health are two fold. One is local and the other systemic. The local effects are based on the physical properties of the food (texture, stickiness, clearance rate, etc.), and the systemic effects are based on the micronutrient requirements of the oral tissues and supporting immune system.
It seems that in approximately 70% to 80% of dental health problems, there is a direct relationship between oral hygiene, local nutritional effects, and oral health. When oral hygiene is the major factor, if plaque is controlled, so is dental disease.
In 20% to 30% of cases, oral hygiene does not appear to be the major factor. Even exceptional oral hygiene is often unable to control the oral disease process because systemic resistance is impaired due to an immune deficiency problem.(ie. Avitaminosis, Type II Diabetes, Acquired Immune Deficiency Syndrome etc.)
In approximately 2% or less of cases, a lack of proper oral hygiene does not adversely affect oral health. Diet and lifestyle are such that systemic immunity to disease is adequate to prevent oral health problems in spite of poor oral hygiene.
It is possible to make up for high concentrations of refined carbohydrate in the "modern civilized diet" with a refined or civilized oral hygiene program (ie. tooth brushing and flossing). Fluoride supplementation can also be used to make the teeth resistant to a poor diet and dental decay. However, when it comes to optimal overall health, there is no substitute for balanced meals and proper nutrition.
by Dr. William
Preventodontics/ n. the art and science of preventive/preventative dentistry practiced with the goal of preventing tooth damage or loss by helping patients to keep their natural dentition healthy for a lifetime. [<Gk (odous odont-, tooth)]
Dentistry was the first of the traditional health professions to make prevention its hallmark Clinical research into the etiology (causes) of dental disease and its prevention have led to a much greater appreciation of both the multi-factorial nature of the human immune response to the disease process, and of the biological harmony or balance we call good health.
Don't be surprised, if in the future patients end up visiting the dentist to find out how well they are aging by their teeth. They may even end up learning about how well their diet pattern and lifestyle is supporting their resistance to disease.
The mouth an the ideal
diagnostic window on health because it is the gateway to
the human body. Everything you eat passes through it, and
if your diet is damaging your teeth and gums, its bound
to negatively affect the health of the rest of your body
too. Because the mouth is so accessible, it can be easily
used to demonstrate the effects of oral hygiene (ie.
brushing & flossing) and various diet patterns on
oral hard and soft tissue relationships.
Current research in Preventodontics, carried out by the Y T F L Foundation, is focused on monitoring periodontal tissue response to the chronic irritation caused by common dental PLAQUE accumulations. When a special PLAK-LITE System is used, it causes the almost invisible dental plaque to appear a brilliant yellow-green. This makes it possible to very accurately evaluate the effectiveness of each patient's oral hygiene. By using a computer assisted Y T F L Oral Health Evaluation System.(O.H.E.S.), we are then able to cross-index the relationship between oral hygiene and gingival health.
This makes it possible to monitor the degree of a patient's tissue immunity response to chronic irritation or infection over time. Patients with high and low susceptibility to periodontal disease can then be targeted for special diet pattern analysis.
By comparing and contrasting and the diet patterns of patients of both strong and impaired resistance to periodontal disease, it becomes possible to highlight those nutritional factors that support both immunity to dental disease and excellent systemic health.
This new interceptice diagnostic approach focuses on the symptomology of both health and disease in a comparative way. We have already begun the development of a new Y.T.F.L. Dental/Medical Health Evaluation System that we hope to have tested by an interdisciplinary research team of dentists, hygienists, physicians, nurses and nutritionists. This prevention based approach to health evaluation has very positive implications in both dentistry and medicine. It may also help to shift the focus of our health care system to one in which interceptive diagnostics and prevention of disease receive more attention than the treatment of its effects. I will do my best to keep you posted on our progress. Keep Smiling!
1. In 1987 the Canadian Dental Association Board of
Governors approved the "5 Point Prevention
Plan" as the cornerstone of their National Dental
When you have orthodontic appliances, you must be sure to brush your teeth and gums better than ever before. Special attention must be paid to the area between the gums and the appliances. We call this the "Danger Zone". Bacteria can breed in the food that collects around your bands and wires causing stains, cavities, unpleasant odours, and gum infections. This is why it is so important to keep your teeth spotlessly clean. Take your time and do it right. A "Water Pik" irrigator can be helpful, if used carefully, but it is not a substitute for careful brushing and other cleaning methods.
Your diet is very important because appliances make your mouth more difficult to clean. Remember that sugar is a highly refined carbohydrate and provides a simple high energy food source for breeding bacterial PLAQUE. White flour products and pre-sweetened cereals can also be very sticky when eaten by themselves. However, it is not just the amount of sugar, or the stickiness of the flour, it is the length of time it remains in the mouth, and the number of times it is eaten during the day.
It is also very important to avoid foods that are hard and brittle, as well as foods that are soft and sticky, because they tend to bend wires, loosen cement under bands and brackets, and break the tubes which are attached.
These are some examples of Foods to Avoid:
HARD, BRITTLE FOODS
SOFT, STICKY FOODS
Certain foods can be eaten if they are served in a special way. Whole fruits and vegetables, such as apples and carrots, should be sliced and eaten carefully. Hard, crusty breads should be broken and eaten in small pieces. Fresh corn may be eaten if sliced off the cob. Do not suck on lemons or limes and avoid carbonated beverages. Please exercise caution in your selection of food and help us achieve the best results possible.
Treat your appliances as
expensive, fine pieces of jewelry; in a real sense, this
is what they are. The extra cleaning and dietary
restrictions may seem to be a hassle, but they are the
secret to preventing problems and building a healthy
NOTIFY THIS OFFICE
"PREVENTION IS THE BEST PROTECTION"
While it has been recognized that nutrition has a prime role to play in dental caries, the role of nutrition in periodontal disease is considerably less obvious. Complicating factors include a complex aetiology and the difficulty in assessing the severity and progress of the disease. The multi-factorial nature of periodontal disease creates problems when studies are designed to analyze single variables. The effects of nutritional status on periodontal health involve more than 50 nutrients and their interaction both locally and systemically. The criteria of tooth mobility and pocket depth add to the difficulty in that they tend to be somewhat subjective for precise measurement.
It has been reasoned that some positive benefits may be seen through the local effects of food. For example, firm fibrous foods provide additional chewing which tends to increase salivary flow, strengthen periodontal ligaments, and increase alveolar bone density through increased physiologic function. Also, these foods do not promote PLAQUE formation because they are non-retentive.
In addition to the local effects, it is
felt by many researchers that poor nutrition may decrease
host resistance to the disease process or modify the
progress of existing lesions. This is certainly true for
gross deficiencies of a specific micro-nutrient. For
example, the lack of vitamin C (Ascorbic Acid) in scurvy,
the lack of vitamin B1 (thiamine) in beri-beri, and the
lack of vitamin B3 (niacin) in pellagra et cetera.
However, when it comes to the effects of more subtle or
borderline deficiencies, analysis becomes more difficult.
Such deficiencies may not produce consistent or easily
identifiable "deficiency disease" symptoms and
therefore, their relationship to possible weakness on a
cellular level (that could affect host resistance to
periodontal problems), is extremely difficult to define.
|DENTAL HEALTH AWARENESS FOR
Hettenhausen DDS, Executive Director
Times are changing. Clinical research in primary prevention and nutrition have led to a comprehensive understanding of the etiology (underlying causes) of dental pathology. Effective Community Dental Health Awareness Programs can cause a dramatic decrease in the incidence of dental disease, and new restorative methods and materials have made even a heavily damaged dentition (teeth & gums) reparable. Because these changes have occurred slowly and relatively recently, there are still people who are unaware of the benefits of regular preventive dental care. A large percentage of our senior citizens fall into this category. The vast majority of them grew up in an era when dentistry most often meant the painful loss of teeth and the fitting of dentures. When dental disease is considered inevitable, care and repair is often neglected, and a "wait until it hurts" attitude results. Not only is this painful and expensive, but it ignores the potential of regular preventive care and prosthetic rehabilitation.
The mouth is the gateway to the body, and a little care and awareness can have a dramatic effect on the incidence of both the acute and chronic problems associated with poor dental health. Since 1989, Y T F L has continued to work with the Thunder Bay Dental Association and Hygiene Society to develop a special "Healthy Smiles for Seniors" program to service the needs of the older adults in our community. We have given both the staffs and residents of three local senior citizens' homes a Y.T.F.L. dental health orientation program entitled, "What a Difference a Little Care Makes". We also have provided a free screening sessions for residents along with a general needs assessment report.
The seniors in our community have made an invaluable contribution to the quality of life that we often take for granted. By helping them to enjoy the benefits of a healthy smile we are repaying an old debt and showing them our gratitude. It is our hope that this effort will form the basis for an ongoing program to help assess and meet the needs of our senior citizens.
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